11 August 2009

You know, Andrew Sullivan has become more and more sane over the years, and I may just have to retire the "Crazy Andy" moniker. It was bestowed during the period he was trying so frantically to reconcile his "conservative" principles with the pig's ear that Bush was making of it all. He's over that, now, and firmly back in the reality-based world. Anyway, he's got a great series he's been running called "The view from your sickbed." A couple of excerpts, with emphasis added, but I don't have anything to add beyond the stories themselves:

When I was 6 months pregnant with my first child, and on complete bedrest, I was laid off. I was unable to look for a new job, being so late into a very difficult pregnancy. My doctors that had worked with me on this high-risk pregnancy were not covered by my husband's insurance company. We decided to use COBRA for me so I could continue to see my doctors of choice. My severance ran out the day my son was born prematurely, with complications from having the umbilical cord around his neck during birth.

The first bill for his expenses came as I was leaving the hospital without my son. When a claim was denied because they said my son had a preexisting condition, that was the final straw.

I was at risk for a kidney stone due to medication I take. I had pain like a kidney stone. I had an x-ray the revealed a kidney stone, and shortly thereafter passed a kidney stone. Still, I was given the CT scan on the slim chance that my pain was something worse and they missed it, leading to a malpractice suit. If rationing means that hospitals give the care you need and not expensive tests that only serve to cover their legal assets, I'll take it.

I work for a national insurance company and it's my job to pay hospitals and clinics for services performed. Now when I say pay, you should think of that in air-quotes. [...] So while your readers are being charged $50 for asprin; my company employs an entire department just to shuffle bills around while they decide what they will pay the hospital for that asprin.

Our twins are preemies - born at 34 weeks. [...] It should have been done in the NICU, but it had been missed. She scheduled us for the following week. She had to order the vax since it was quite expensive (a total of about $16K.) Two days beforehand, she notified us that our insurance company had denied the coverage as too expensive.

We then proceeded to try to get the insurance company to cover the vax. Our doctor called. The NICU doctor called. We had conference calls with them and the insurance company. We worked up the chain of command at the insurance company. We had it done and paid out of pocket. What choice did we have? Finally, we pulled in a specialist and managed to get high enough up the chain to get it approved. By this point, it had become something of a crusade for the various doctors involved. Two weeks later, my company's health insurance premiums went up 30%.

Coincidence? Who knows. But when people talk about rationing under socialized medicine, I always think, "You know, we have rationing now, it just hasn't effected you. Yet." And mine was one of those highly-vaunted "gold-plated" private health insurance policies.

I should be one of the guys conservatives want to help. I started a small consulting business in 2008 - the third time I’ve struck out on my own. The last time I did so, in 2003, I was on COBRA from a previous employer at $365/mo. Now, I’m on COBRA from my last employer at $792/mo. [...] I’m a very healthy 45-year-old, and I’m HIV-positive. My meds work great: no viral load, healthy t-cells. Aside from this, nothing wrong. But I can’t miss even a day in coverage, because the list price for my HIV meds is $1,798/month.

So far, I can handle the $792/mo COBRA, but it certainly puts a damper on my profits. I decided to try and end-run the application game, knowing I’d be rejected. Every rep encouraged me to apply anyway, but applications can take hours to complete – who has all that time? I started telling them upfront I was HIV-positive. None had any advice, save “there might be some California state plan you can apply for…” There’s no central source of information about this, nor does any private insurer have any incentive to help me find a plan – I’m uninsurable. The hours I’ve wasted searching for an answer are turning into weeks. Even those of us that can bite the bullet and tap savings to pay for private plans simply can’t get them.

So while Republicans are screaming about socialism, they ought to look to their attitude on liberty and see if they can’t find some good reasons to support healthcare (insurance) reform, rather than throw a collective childish tantrum. They ought to be mad at themselves for electing that dumbass W who didn’t champion this opportunity to lock in public loyalty for decades when Republicans controlled both Congress and the Presidency. What we got from them was a massive giveaway to seniors to secure the 2004 election - not real, positive long-term fixes to serious long-term problems.

There's one great point that bears repeating: we have rationing now, it just hasn't affected you. Yet.

And this is the glorious Panglossian best of all possible health care systems that the anti-reform activists want so desperately to preserve.

6 comments:

While there are isolated cases where people have to call the customer service rep at an insurance company to get something approved, in Government Healthcareland, the expensive thing that you want will be denied uniformly so no one feels left out.

I lost my insurance coverage 4 days after my son was born. I put on my big girl boots and went back to work in pain. BFD. Don't want the entire health care system to be socialized because my ex-husband got fired the day after Christmas.

Terrific post. "Nurse" K doesn't seem to understand that a public option does not equal "socialization" of the entire health care system. She also doesn't realize that many people don't have a job to go back to. I don't want fifty million people to go without medical care because I'm obsessed with how awesome I am when I put on my big girl boots.

With all due respect to individual intiative and all, I want universal coverage.

It's about herd immunity.

I'm the same species as the people who clean my office, and microorganisms that infect them can infect me. The folks who clean my office can't take sick days unless they're about to die, pretty much, b/c they earn so little and have basically no benefits, so they're in the office when they're sick.

It seems to me that this is a prime vector for any infectious disease - if enough uninsured people in service industries catch a bug, it'll spread like wildfire into the insured group. The lead time to determine that there's an epidemic will be longer b/c it won't be detected until later in the game, because people won't get medical care until they're truly incapacitated....

I'd just assume let people have care; it's better for the survival of the species as a whole.

And I'm sure it's a national security issue. Seriously. Someone with malevolent intent towards the US could use the uninsured as a vector and really cause a lot of harm very quickly.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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